Sarcopenia and its Association with Geriatric Syndromes and Quality of Life in Older Indian Outpatients – A Cross-sectional Pilot Observational Study

Abstract

Background: Despite the huge clinical impact of sarcopenia, there is very little to no data from Indian subcontinent regarding sarcopenia in older adults. We conducted this study to assess the frequency of sarcopenia in Indian older outpatients and its characteristics and associations with various geriatric syndromes and quality of life in Indian older adults. Methods: 100 participants above the age of 65 years were recruited from the outpatient department of Geriatric Medicine of a tertiary care hospital in India. Muscle mass, muscle strength and physical performance was measured by DXA scan (Dual Energy X-ray Absorptiometry), hand-held dynamometer and 4 m gait speed respectively. Sarcopenia was identified using an Asian working group for sarcopenia (AWGS) criteria. Many geriatric syndromes such as osteoporosis, dementia, depression and malnutrition were assessed using DXA scan (Dual Energy X-ray Absorptiometry), HMSE (Hindi Mental State Questionnaire), GDS-5 (Geriatric Depression scale – 5 item questionnaire) and MNA (Mini Nutritional Assessment) respectively. Quality of life was assessed using the OPQOL-brief questionnaire. Results: The preval nce of sarcopenia in our study population was 53% (49.3% in males, 61.3% in females). Hypothyroidism, neurological disease and osteoporosis were the only comorbidities found to be positively associated with sarcopenia. Among geriatric syndromes, nutrition and cognition were negatively associated with sarcopenia. Sarcopeniawas also negatively related to the quality of life. Multivariate stepwise logistic regression analysis showed that osteoporosis (OR: 5.43; 95% CI: 1.57-18.81; p-value: <0.01) was significantly associated with sarcopenia. Conclusion: Sarcopenia was common among Indian older outpatients with increased risk of geriatric syndromes and poor quality of life, therefore, a regular sarcopenia assessment may be considered in elderly patients.

Prevalence and factors contributing to primary sarcopenia in relatively healthy older Indians attending the outpatient department in a tertiary care hospital: A cross‐sectional study

“… 3 An Indian study published in 2019 among outpatients found that 53% had sarcopenia using ASWG 2014 criteria. 10 However, it is noteworthy that most of the research on sarcopenia has included subjects with secondary sarcopenia. A meta‐analysis published in 2020 also concluded that sarcopenia is highly prevalent among older adults with chronic disease conditions.…”

South Asian Working Action Group on SARCOpenia (SWAG-SARCO) – A consensus document

“…An Indian study screened the elderly patients (≥ 65 years; n = 100) presenting to the outpatient department of Geriatric Medicine in a tertiary care hospital for sarcopenia [ 34 ]. The study also used known standardized screening questionnaires and tools to assess various geriatric syndromes, cognition and QoL.…”

“…The study also used known standardized screening questionnaires and tools to assess various geriatric syndromes, cognition and QoL. The study found that osteoporosis, hypothyroidism, and neurological disease were the only comorbidities that correlated positively with sarcopenia [ 34 ]. Of these, only osteoporosis was significantly associated with sarcopenia.…”

“…(P < 0.01). On the other hand, nutrition, cognition, and QoL had a negative correlation with sarcopenia [ 34 ]. In another study on the same patient group, one-repetition-maximum (1-RM) knee extension (1-RMKE) RM knee extension was evaluated to assess lower extremity muscle strength (LEMS) [ 35 ].…”

“…Using AWGS cut-offs can produce results that are not typical of the South Asian community. This was reflected by a study conducted on elderly outpatients (≥ 65 years; n = 100) presenting to the Geriatric Medicine department in a tertiary care hospital from India [ 34 ]. The study used AWGS 2014 cutoffs for hand grip strength (HGS), gait speed, and ASMI to diagnose sarcopenia.…”